Volume 14, Supplement 1
Original Article / Published: April 2026
DOI: https://www.doi.org/10.57045/jemis/1410426.pp27-28
R. Kostadinov, V. Mihaylov, Ts. Trichkov , N. Vladov
Clinic of Hepato-Pancreatic Surgery and Transplantation, Military Medical Academy – Sofia
Abstract
Introduction: Laparoscopic liver surgery has undergone remarkable development over the past 25 years. Owing to its advantages – reduced intraoperative blood loss, shorter hospital stay, and lower postoperative morbidity – while maintaining comparable oncologic outcomes, it has become an accepted approach for both benign and malignant liver lesions.
Matherials and methods: A retrospective analysis of our institutional database was conducted to identify patients who underwent laparoscopic liver resection (LLR) for colorectal cancer liver metastases (CRCLM). Perioperative outcomes were compared with those of patients undergoing open liver resection (OLR) for the same indication. Between January 2009 and January 2026, a total of 567 liver resections with curative intent for CRCLM were performed, of which 103 were completed laparoscopically. Two-stage hepatectomy with laparoscopic portal vein branch ligation was carried out in 7 patients, and simultaneous colorectal and liver resections were performed in 16 cases.
Results: The median patient age was 60 years (range 27–78), with a predominance of male patients (n=54). Among the 103 laparoscopic procedures, 42 were major liver resections, including 36 right hepatectomies, 2 left hepatectomies, and 4 trisectionectomies. The mean operative time was 216 minutes (range 96–378), and the median postoperative hospital stay was 6 days. A total of 23 complications occurred in 18 patients. Major postoperative morbidity (Clavien–Dindo grade ≥III) was observed in 4 patients (4%). Compared with the open approach, the laparoscopic group demonstrated a significantly longer duration of the Pringle maneuver (38 vs. 23 minutes, p<0.05) and operative time (247 vs. 196 minutes, p=0.046). However, LLR was associated with significantly lower rates of blood transfusion (p=0.031) and major morbidity (p=0.002).
Conclusion: Extensive experience in open liver surgery, combined with a meticulous laparoscopic technique, is essential for the successful implementation of a laparoscopic liver surgery program. Our findings demonstrate that LLR for CRCLM is associated with reduced major postoperative morbidity, supporting its role as a safe and effective alternative to open resection.
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How to cite this article:
R. Kostadinov, V. Mihaylov, Ts. Trichkov , N. Vladov. Laparoscopic liver resection for colorectal cancer liver metastases. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2026; 14(1): 27-28
Corresponding author:
Dr. Radoslav Kostadinov MD
Clinic of Hepatо-Pancreatic Surgery and Transplantology
Military Medical Academy, Sofia
Email: radokost@gmail.com
Mobile: +359 88 627 9067